BG Medical Random Question Thread

[Byrthnoth]

Mine weren't even fighting. Everything was in-network, albeit from a healthcare provider that doesn't own buildings (Aetna? Blue Cross Blue Shield? idr)

I'm on Kaiser now and haven't had the problem again.

[Outlaw]

What is the best over the counter cold medicine now? It's been a while since I had to get some so I don't know.

[Gredival]

What is the best over the counter cold medicine now? It's been a while since I had to get some so I don't know.

Cold medicine is all therapeutic. The only thing to note is that it has been determined that oral phenylephrine is ineffective, so avoid it if you are looking for something that includes decongestion.

[kuronosan]

Cold medicine is all therapeutic. The only thing to note is that it has been determined that oral phenylephrine is ineffective, so avoid it if you are looking for something that includes decongestion.

Oh you read the systematic review of four articles, two of which were at high risk of bias and the other two which stipulated it was ineffective at treating congestion due to allergies?

Not the same thing as treating colds, but sure. We'll just make it fit.

If you want to treat congestion you can still use phenylephrine nasal spray or oxymetazoline. They're still pretty effective.

Most oral decongestants aren't very bioavailable, but sprays go straight to work. If I was trying to treat sinus congestion I'm not taking a pill.

[Byrthnoth]

I remember when they switched from pseudoephedrine to phenylephrine in cold meds my freshman year of college and suddenly nothing worked anymore. For me:
* Systemic Pseudoephedrine (Sudafed) - works.
* Systemic Phenylephrine (cold meds between about 2005 and 2025) - has never worked.
* Nasal spray Oxymetazoline (Afrin) - works incredibly well, but I rebound about 20 hours after a single pump dose. IIRC they say it rebounds after 3 days because that was the first time point they tested.

Gred is correct that they're all therapeutic and there isn't great (or any) evidence that they make colds shorter. If I'm in the middle of a week of cold and need a night of respite for some big event the next day, I make my deal with the Afrin devil and don't regret it.

[Gredival]

Oh you read the systematic review of four articles, two of which were at high risk of bias and the other two which stipulated it was ineffective at treating congestion due to allergies?

Not the same thing as treating colds, but sure. We'll just make it fit.

If you want to treat congestion you can still use phenylephrine nasal spray or oxymetazoline. They're still pretty effective.

Most oral decongestants aren't very bioavailable, but sprays go straight to work. If I was trying to treat sinus congestion I'm not taking a pill.

I specifically said "oral phenylephrine" AND I said that cold medicine is about treating symptoms? Nothing you said is contrary to what I said.

[kuronosan]

Yes. But unlike other Robin Hoods, I can talk with an English accent.

[Outlaw]

Really hitting me hard now. I thought it was a chest cold at first but its moved to my head. Severe sinus congestion and pain. The only thing I have is Ibuprofen. I guess I'm going to have to get some Pseudoephedrine. I don't want to because it makes me feel a little jittery but it's the only thing that helps when it gets this bad. The pharmacist will probably try to talk me out of it. They have tried to do that in the past.

[kuronosan]

Don't use that if you're jittery from it. Use Afrin/Oxymetazoline. Usually has less side effects but you can't use it for very long.

I might ask your pharmacist about that instead.

[Outlaw]

I think I'm getting better now. (It's incredible how much mucus your body can produce) I ended up getting Pseudoephedrine. I had too. Whenever I have a bad cold, or whatever this was, it takes full advantage of my compromised immunity and my head fills up with fluid. Completely blocked, splitting pain, can only breath out of my mouth. The medicine didn't seem to affect me like I remember but I only took 30mg every six hours. Just enough to open my nasal passages a bit so I could breath. Stopped taking it yesterday since the worst is over I hope.
I'm still blowing out, coughing up the gnarliest shit you have ever seen.

[Gredival]

Medical professionals of BG, I am looking for reading materials about fixing the American healthcare system.

Ideally, I'd like something that focuses on national health insurance but open to anything. Preferably something written post-pandemic.

[Richybear]

https://en.wikipedia.org/wiki/Luigi_Mangione

[Gabai]

https://en.wikipedia.org/wiki/Luigi_Mangione

Bravo

[kuronosan]

https://en.wikipedia.org/wiki/Luigi_Mangione

I lold

[Buffy]

I've applied to be included in an ReCET study. Any bluegartr medical bros want to warn me off?

[kuronosan]

I'm sorry, I can't. Doing that might actually affect the outcome of the study if you're selected.

They'll stick a catheter in your stomach like they're doing an endoscopy and use a small electric pulse (or sham). Supposedly helps your cells grow back healthier.

[Talus]

Sham treatments are interesting. Before med school I worked at a retina practice where there was a study looking at PRP (panretinal photocoagulation) for diabetic retinopathy and there was a treatment arm and a sham treatment arm and the doc didn't know which arm the patient was in until they opened an envelope from the study coordinator. The problem was when they stepped on the pedal for the laser, there was an audible sound. With the sham treatment, one of the ophthalmologists noted that and said, "Am I supposed to go beep boop when I sham laser a patient?!" Which was pretty hilarious to me as a third party in the room (ophthalmic tech at the time).

Sham is super easy when it's an injection of saline or something instead of an actual investigational agent. Anyway, I always got asked why I went into anesthesiology not ophthalmology when people knew I was a retina tech before, and the answer was easy - lifestyle is better in ophtho in most settings, but I loved the acuity, procedures, and physiology of anesthesiology.

The other funny thing about ophthalmology is if you have limited exposure to it, their notes read like hieroglyphics (even to other docs in different specialties).

[Buffy]

I've got a pretty serious case of type 2 diabetes which I have struggled to get under control for multiple years. I'm 49 and was initially diagnosed around 8 years ago. My A1C has fluctuated between 7-11 based on my meds and my attention to the disease/diet/exercise. I've also had blood pressure as high as 180/140 and never below 140/110 even on meds.

3 months ago we changed some meds. I changed my GLP1 from ozempic to monjaro, my blood pressure medicine to amlodipine. I also started being more consistent with my diet and exercise.

My blood pressure went down 40 points (160/120 > 120/80) and my weight went down 35 pounds in 3 months and my A1C hit 6.8 (under 7 for the first time in a long time). Also I had no nausea on the Monjaro, where I threw up multiple times a week on the Ozempic. It's the first time in like 5 years I've felt like I've made real progress in managing my diabetes and high blood pressure.

BUT I had an elevated CREAT (1.64) and BUN (28).

My PCP and I discussed it, I felt I might not be drinking enough water, so we decided to retest. I hydrated really well for 3 days, tested again. CREAT 1.79 and BUN 31.

I'm FREAKING out. I'm worried I've started down the path to progressive/permanent kidney damage and eventual need for stuff like dialysis.

I'm so mad at what I've done to myself, this was all self inflicted with Red Bulls, Milky Ways, and sitting on my ass playing video games through my 20s.

Anyone dealt with this before? My daughter is 6. I want to make it to her 25th birthday. Am I going to make it to October 5th, 2044. I'm so scared of letting her down.

[Salodin]

I've got a pretty serious case of type 2 diabetes which I have struggled to get under control for multiple years. I'm 49 and was initially diagnosed around 8 years ago. My A1C has fluctuated between 7-11 based on my meds and my attention to the disease/diet/exercise. I've also had blood pressure as high as 180/140 and never below 140/110 even on meds.

3 months ago we changed some meds. I changed my GLP1 from ozempic to monjaro, my blood pressure medicine to amlodipine. I also started being more consistent with my diet and exercise.

My blood pressure went down 40 points (160/120 > 120/80) and my weight went down 35 pounds in 3 months and my A1C hit 6.8 (under 7 for the first time in a long time). Also I had no nausea on the Monjaro, where I threw up multiple times a week on the Ozempic. It's the first time in like 5 years I've felt like I've made real progress in managing my diabetes and high blood pressure.

BUT I had an elevated CREAT (1.64) and BUN (28).

My PCP and I discussed it, I felt I might not be drinking enough water, so we decided to retest. I hydrated really well for 3 days, tested again. CREAT 1.79 and BUN 31.

I'm FREAKING out. I'm worried I've started down the path to progressive/permanent kidney damage and eventual need for stuff like dialysis.

I'm so mad at what I've done to myself, this was all self inflicted with Red Bulls, Milky Ways, and sitting on my ass playing video games through my 20s.

Anyone dealt with this before? My daughter is 6. I want to make it to her 25th birthday. Am I going to make it to October 5th, 2044. I'm so scared of letting her down.

I know it's an anxiety producing situation, but you're doing the right things and you shouldn't feel bad or guilty about it.

The weight and blood sugar are the more important things to get under control and manage, so don't regret that just cause creat and bun is escalating. Keep eating healthy, cause you're trading a myraid of weight and blood issues for different and less life threatening issues. I doubt your kidneys are dying because you decided to reach a healthy weight; it was likely never a either/or situation, but a "all this is wrong with you atm and you should try to remove as many of them as possible at your age" situation.

I started glps I think almost 2 years ago at this point. Lost 50lbs on the journey, and am at my maintenance weight now. Ozempic gave me similar issues, but once I started retatrutide I've felt zero negative symptoms and life has been grand.

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[archibaldcrane]

Ozempic is trash, it's ridiculous docs are still prescribing it.

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